Provider Demographics
NPI:1790210557
Name:BUTTERFLY MEDICINE
Entity Type:Organization
Organization Name:BUTTERFLY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THI
Authorized Official - Middle Name:HUONG
Authorized Official - Last Name:NGUYEN-PHUOC
Authorized Official - Suffix:
Authorized Official - Credentials:ND, PT, LAC
Authorized Official - Phone:832-607-6501
Mailing Address - Street 1:6850 35TH AVE NE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-7344
Mailing Address - Country:US
Mailing Address - Phone:832-607-6501
Mailing Address - Fax:
Practice Address - Street 1:13323 23RD PL NE
Practice Address - Street 2:APT B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4213
Practice Address - Country:US
Practice Address - Phone:832-607-6501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-28
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60692341261QM2500X
WAPT60248920261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy